Michigan Women Sue the State So They Can’t Be Forced to Be Incubators

They're trying to ensure that what happened to Adriana Smith in Georgia can't happen to any pregnant person in Michigan.

By Susan Rinkunas | October 24, 2025 | 11:14am

Photo: iStockphoto Politics

Michigan Women Sue the State So They Can’t Be Forced to Be Incubators

Multiple women and physicians filed a lawsuit in Michigan on Thursday, effectively asking the state not to turn pregnant people into incubators if they become incapacitated. That’s not a hypothetical concern, as we saw in Georgia earlier this year. And yes, it’s still a concern even in a state where abortion is legal.

The lawsuit challenges a Michigan law that overrides patients’ advance medical directives if they’re pregnant; advance directives are legal documents that spell out people’s choices for end-of-life medical care. But Michigan is one state of many states that restricts people’s rights if they’re pregnant, meaning hospitals can force unwanted medical interventions like life support in order to protect potential fetal life. These laws are fundamentally fetal personhood statutes, giving legal rights to embryos and fetuses that supplant the rights of the person gestating them.

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More than 30 states have advance directive laws containing a so-called “pregnancy exclusion,” per the reproductive justice law firm If/When/How, but Michigan is the only one that broadly protects reproductive rights in its constitution. The plaintiffs argue in the complaint that the pregnancy carve-out violates the amendment voters passed in 2022 to codify reproductive freedom into the state constitution. The text of that amendment said, among other things, that residents would have “the right to make and effectuate decisions about all matters relating to pregnancy.” So, yes, a pregnancy exclusion would seem to violate the Michigan Constitution.

The plaintiffs—three women with advance directives and four physicians who provide pregnancy or end-of-life care—are represented by end-of-life care organization Compassion Legal and If/When/How. The groups partnered earlier this year on a similar lawsuit in Kansas, which is ongoing, and won a previous case in Idaho in 2021. State lawmakers in Washington and Colorado repealed their pregnancy exclusions in 2025 and 2021, respectively.

Compassion Legal senior staff attorney Jess Pezley said in a statement that “denying individuals the right to refuse treatment because they are pregnant is fundamentally at odds with the Michigan Constitution.”

A case at the intersection of advance directive laws and abortion bans made international headlines earlier this year. A 31-year-old Georgia woman named Adriana Smith was declared brain dead in February when she was 9 weeks pregnant. A hospital forced Smith’s family to keep her on life support for three months until doctors performed a C-section to “deliver” the baby, citing the state’s ban on abortions after about 6 weeks of pregnancy. (The surgery was done at 25 weeks gestation, though they’d hoped to keep her alive until 32 weeks.)

The decision of whether to put Smith on life support “should have been left up to the family,” Smith’s mother, April Newkirk, told a local NBC affiliate in May. “I’m not saying we would have chose to terminate her pregnancy, what I’m saying is, we should have had a choice.”

Georgia’s medical-consent law does allow people to make pregnancy-related choices in advance directives, though pregnant people can only refuse treatment when their fetus isn’t viable, meaning it can’t survive outside the uterus. It’s not clear if Smith had an advance directive, but if she didn’t, choices about her care should have rested with her mother. However, the hospital in this case claimed that the state’s abortion ban prevented them from taking Smith off life support until the fetus was viable. Republican politicians claimed the law doesn’t mean that, but the hospital’s lawyers weren’t willing to take the risk given the threat of prosecution.

A decade before Smith’s case, and years before the Supreme Court overturned Roe v. Wade, Texas kept Marlise Muñoz on life support despite her expressed wishes. In late 2013, Muñoz was declared brain dead after suffering a pulmonary embolism at 14 weeks pregnant, but the hospital kept her alive due to the pregnancy exclusion in the Texas Advance Directives Act. Her husband sued, and a judge ordered the hospital to take her off life support after two months. The judge said the pregnancy exclusion didn’t apply to a person who is legally dead—logic that should have applied in Smith’s case as well. Still, every pregnant person deserves to make their own choices, which is why these laws need to be repealed.

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